[Eating disorders - diagnosis and characteristics]. / Zaburzenia odzywiania ­ rozpoznanie i charakterystyka.

Eating disorders are characterized by eating and appetite disorders, which develop on a mental basis. Currently, there is a rapid increase in the frequency of these disorders, especially among children and adolescents. Eating disorders include anorexia nervosa, bulimia nervosa and EDNOS, which include a dozen or so disorders, but this group is still expanding. Eating disorders are characterized by the highest mortality rate among all mental illnesses. They mainly affect adolescents and young adults as well as the female sex, however, there are more and more cases among men and people from other age groups. Anorexia nervosa is the conscious reduction of food intake in order to reduce body weight. In this disorder there is abnormal body image, underweight and fear of weight gain. According to the American Psychiatric Association, there are two types of anorexia nervosa - restrictive (limiting) and bulimic (laxative). Bulimia nervosa is characterized by abnormal food intake (overeating) and co-occurrence of compensatory methods aimed at limiting the absorption of consumed food. These methods include: provoking vomiting, excessive physical effort, taking diuretics and laxatives. Among the eating disorders we also distinguish eating disorders not defined otherwise (EDNOS). This is a group of diseases in which pathological eating behaviour occurs, but they do not meet the diagnostic criteria of anorexia or bulimia. The diagnosis of eating disorders is difficult not only because of the lack of specialists dealing with this subject, but also because of the lack of public awareness of these diseases. That is why it is so important to educate both medical staff and the general public about eating disorders.

Nutrition knowledge of people with eating disorders

Background: Eating disorders are an increasingly common health problem that is a major therapeutic challenge. For many years, the basic form of therapy used to be psychiatric and psychotherapeutic treatment, but now it is postulated that the dietetician should also be part of the therapeutic teams. Objective: The main purpose of the study is to assess nutrition knowledge of people with eating disorders with consideration to their age, place of living, education, BMI, type of disease, participation in dietary consultations and in therapy. Material and methods: Nutrition knowledge of the respondents was assessed by means of an author's survey questionnaire. The questionnaire was published in one of the social portals in the "Eating disorders ­ tackling" group gathering people with different types of eating disorders. The survey questionnaire consisted in 33 questions. Arithmetic mean and standard deviation for the number of correct answers provided by the respondents by the selected criteria. Results: In terms of age, the least nutrition knowledge was attributable to the persons below 20 years of age (25.24 points in average). When considering the place of living, the least nutrition knowledge was revealed among the subjects living in medium cities (between 20 and 100 thousand of population) i.e. 25.31 points. In terms of education, the least nutrition knowledge was recorded in people with vocational education (24.83 points). When classifying the respondents by BMI, the highest average score was gained by the respondents with normal body mass index (BMI) (26.42 points). Conclusions: The study on the level of nutrition knowledge among the people with eating disorders demonstrated that this knowledge was selective and insufficient to provide rational nutrition. It aimed at teaching the rules of healthy lifestyle and nutrition and thorough discussing of all nutrients, their functions and effect on the body.

I Am the 1 in 10-What Should I Eat? A Research Review of Nutrition in Endometriosis.

Endometriosis is a chronic, painful, estrogen-related inflammatory disease that affects approximately 10% of the female population. Endometriosis has a significant negative impact on quality of life. Nutrition may be involved in the development and severity of endometriosis. The purpose of this paper is to discuss in detail the nutritional recommendations for patients with endometriosis. This article discusses the importance of nutrients such as polyphenols, vitamins C, D and E, PUFAs, and iron in the development of endometriosis. Alternative diets, such as the Mediterranean, anti-inflammatory, vegetarian, low-nickel and low-FODMAP diets, have also been presented in the context of their potential beneficial effects on the course of endometriosis.

Depressive disorders among long-term care residents in the face of isolation due to COVID-19 pandemic. / Zaburzenia depresyjne wsród pensjonariuszy osrodka opieki dlugoterminowej w obliczu izolacji spowodowanej pandemia COVID-19.

OBJECTIVES: The main aim of this study was to assess the effects of social and familial isolation due to COVID-19 on the mental well-being of patients staying in a residential medical care facility and evaluation of the effectiveness of therapeutic measures. METHODS: The study was conducted among the patients of a residential medical care facility (58 patients). A short form of the Geriatric Depression Scale (GDS) was used to assess the severity of depressive disorders. The number of medical and psychological interventions during the individual months of isolation was also compared. RESULTS: In February 2020, when there was no isolation, 87.9% of the study group did not suffer from depression compared to 72.4% during the period of full isolation. After introducing controlled methods for contacting loved ones, the number of individuals with no depressive symptoms increased again. A mean of 1.76 medical and 0.23 psychological interventions per one patient were conducted during the period of full isolation. CONCLUSIONS: The number of medical and psychological interventions was higher during the period of full isolation compared to months without compulsory isolation due to COVID-19. After the introduction of full isolation, the scores in the GDS were significantly higher, which means that the residents were at a higher risk of depressive disorders than in the months without isolation.

Nutritional Therapy in Persons Suffering from Psoriasis.

Psoriasis is a chronic inflammatory skin disease. Immunological, genetic, and environmental factors, including diet, play a part in the pathogenesis of psoriasis. Metabolic syndrome or its components are frequent co-morbidities in persons with psoriasis. A change of eating habits can improve the quality of life of patients by relieving skin lesions and by reducing the risk of other diseases. A low-energy diet is recommended for patients with excess body weight. Persons suffering from psoriasis should limit the intake of saturated fatty acids and replace them with polyunsaturated fatty acids from the omega-3 family, which have an anti-inflammatory effect. In diet therapy for persons with psoriasis, the introduction of antioxidants such as vitamin A, vitamin C, vitamin E, carotenoids, flavonoids, and selenium is extremely important. Vitamin D supplementation is also recommended. Some authors suggest that alternative diets have a positive effect on the course of psoriasis. These diets include: a gluten-free diet, a vegetarian diet, and a Mediterranean diet. Diet therapy for patients with psoriasis should also be tailored to pharmacological treatment. For instance, folic acid supplementation is introduced in persons taking methotrexate. The purpose of this paper is to discuss in detail the nutritional recommendations for persons with psoriasis.

Assessment of the Risk of Depression in Residents Staying at Long-Term Care Institutions in Poland During the COVID-19 Pandemic Depending on the Quality of Cognitive Functioning.

Background: The development of the COVID-19 pandemic has prompted the implementation of many procedures to safeguard against further increases in illness. Unfortunately, this has drastically reduced residents' contact with their families, which has increased feelings of loneliness and isolation. This is particularly difficult in long-term care facilities, where the risk of developing depression is higher than in the general population. Objectives: The aim of the study was to assess the risk of depression among the residents of long-term care institutions in Poland during the COVID-19 pandemic and to determine the relationship between the risk of depression and the occurrence of cognitive impairment in the study group. Methods: The study included 273 residents from long-term care institutions in Poland. The risk of depression was determined based on an originally designed questionnaire. The cognitive state of the subjects was assessed using the screening test Mini-Mental State Examination (MMSE). Both the depression risk assessment and the MMSE test were conducted twice: in March and December 2020. Results: In March, severe dementia was present in 28.2% of the residents and normal MMSE scores were observed in 16.1% of the subjects; in December, the prevalence of severe dementia increased to 31.1% and that of normal scores decreased to 10.3%. In March, no participant was found to be at high risk of depression and moderate risk was observed in 14.3% of the subjects; in December, 2.6% of the residents had a high risk score and 45.4% had a moderate risk score. Statistical analysis revealed that higher MMSE scores correspond with a higher risk of depression. Conclusion: A higher risk of depression was observed with the development of the pandemic. Residents with cognitive impairment were characterised by a lower risk of depression compared to individuals with normal MMSE scores. During the study, progression of cognitive impairment was observed in the residents.

Nutritional and Non-Nutritional Predictors of Low Spot Urinary Creatinine Concentration in Patients with Heart Failure.

Low spot urinary creatinine concentration (SUCR) is a marker of muscle wasting and clinical outcome. The risk factors for low SUCR in heart failure (HF) remain poorly understood. We explored the risk factors for low SUCR related to poor outcomes. In 721 HF patients (age: 52.3 ± 11 years, female: 14%, NYHA: 2.7 ± 0.7) SUCR and Dexa body composition scans were performed. BMI prior HF-onset, weight loss, and appendicular muscle mass were obtained. Each patient was classified as malnutrition or normal by GLIM criteria and three other biochemical indices (CONUT, PNI, and GRNI). Sarcopenia index (SI) as creatinine to cystatin C ratio was also calculated. Within 1 year, 80 (11.1%) patients died. In ROC curve we identified a SUCR value of 0.628 g/L as optimally discriminating surviving from dead. In low SUCR group more advanced HF, higher weight loss and catabolic components of weight trajectory (CCWT), more frequent under-nutrition by GLIM, and lower SI were observed. In multivariate analysis the independent predictors of low SUCR were SI, CCWT, and GNRI score. In conclusion: the risk of low SUCR was associated with a worse outcome. Low SUCR was associated with greater catabolism and sarcopenia but not with biochemical indices of malnutrition.